
AN INVESTIGATION OF THE RELATIONSHIP BETWEEN THE
eNOS GENE POLYMORPHISM AND DIAGNOSED MIGRAINE Güler S1,*, Gürkan H2, Tozkir H2, Turan N3, Çelik Y1 *Corresponding Author: Sibel Güler, M.D., Department of Neurology, Trakya University Faculty of Medicine,
Balkan Yerleşkesi, 22030 Edirne, Turkey. Tel: +90-284-236-49-81. Fax: +90-284-223-42-03. E-mail: drsibleguler@
yahoo.com page: 49
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MATERIALS AND METHODS
Participants. A total of 300 individuals, comprising
175 migraine patients [25 (14.3%) males, 150
(85.7%) females] and 125 controls [28 (22.4%) males
and 97 (77.6%) females] were recruited. Local ethics
committee approval was obtained from the Trakya
University Medical Faculty Ethics Committee on
13 February 2013, and the official writing number
is 2013/26. The participants with migraine had all
been referred to the Trakya University Medical Faculty
Neurology Policlinic, Edirne, Turkey between
January 2013 and December 2013, and had been diagnosed
according to the International Classification of
Headache Disorders (ICHD-II) criteria [6]. The need
to recruit 103 cases to both patient and control groups
was calculated on the basis that polymorphisms might
be observed as 0.34 in the control group, and an odds
ratio (OR) of 2.21, so in order to find an eNOS polymorphism
association at 80.0% power, 300 people
consisting of 175 patients and 125 controls were
recruited. Patients who had cardiovascular, renal,
hepatic, gastrointestinal, pulmonary, endocrine, oncologic,
autoimmune, respiratory and inflammatory
diseases were excluded. Controls were selected randomly
among people who had no cardiovascular,
renal, hepatic, gastrointestinal, pulmonary, endocrine,
oncologic, autoimmune, respiratory, inflammatory
and psychiatric diseases.
Genotype determination. Peripheral blood
samples from both patients and controls were drawn
into 2 mL EDTA tubes. DNA isolation from peripheral
blood samples were performed using Qiagen DNA
isolation kits (EZ1® DNA Blood 200 μL Kit; Qiagen,
Hilden, North Rhine-Westphalia, Germany) with an
EZ1 Advanced XL (Qiagen) Nucleic Acid Isolation
system. Consequently, DNA concentration and purity
of isolated DNA samples was measured using a
NanoDrop device [NanoDrop 2000C; Thermo Fisher
Scientific Inc., Wilmington, MA, USA]. After measurement
of concentration and purity, amplification
polymerase chain reaction (PCR) for pyro-sequencing
was performed according to the manufacturer’s recommended
PCR protocol, using a PyroMark PCR
kit (Qiagen) and primers in a PyroMark Custom
Assay Kit (Qiagen) for detection of each polymorphism,
such as rs743506, rs207468799, rs3918226,
rs2070744, rs1799983, rs148554851 and rs180079.
Amplification PCR performed with initial denaturation
at 95 °C for 15 min., followed by 45 cycles at
94 °C for 30 seconds, 60 °C for 30 seconds, 72 °C for
30 seconds, and a final extension 72 °C for 10 min.
After PCR amplification, PCR products were
pyro-sequenced to detect each polymorphism using
sequencing primers from a PyroMark Custom Assay
Kit, according to the manufacturer’s instructions (PyroMark
Q24 System; Qiagen). The results were then
analyzed using the PyroMark Q24 software system
(Qiagen), and the genotypes for polymorphisms were
determined using samples from both controls and
patients (Qiagen). Statistical analyses. Statistical evaluation was
performed using the Statistical Package for the Social
Sciences (SPSS Inc., Chicago, IL, USA) (SPSS
v21) statistics software. One sample Kolmogorov-
Smirnov test was used to assess the eligibility for
normal distribution of measured data, and since the
data did not show a normal distribution, the Mann
Whitney U test and the Kruskal-Wallis analysis of
variance were used for comparison between groups.
Pearson’s c2 test, Fisher’s exact c2 analysis and the
Kolmogorov-Smirnov two-sample test were used to
analyze qualitative data. Median (minimum-maximum)
values and mean value ± standard deviation
(SD) were determined as descriptive statistics. The
significance limit was set at p <0.05 for all statistics.
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